Single Tracks Blog Archive

How Your New Contract Physician Group Killed Your Bundled Payment Program

After several months of negotiations you've reached agreement with a contract physician group to provide hospitalist services in your hospital. This group has particular expertise in helping patients with multiple comorbidities and focuses on making sure that those patients get into the proper post-acute setting, which you hope will improve your performance in the Medicare Bundled Payment for Care Improvement (BPCI) CHF and COPD episodes in which you’re participating.

National Bundled Payment Summit 2015 Presentation - Video

At the National Bundled Payment Summit in Washington DC last June, we presented a session on risk and opportunity in bundled payments. Jon Pearce from Singletrack Analytics gave an overview of risk and opportunity in bundled payments, while Jessica Walradt from the Association of American Medical Colleges and Lily Pazand from NYU Langone Medical Center discussed successes and challenges in their related organizations.

Choosing Fracture-Based Targets in BPCI

CMS has made the option available to BPCI participants to have their targets for the Major Joint Replacement of the Lower Extremity episodes stratified by whether the patient had a hip fracture. This issue is of concern to some BPCI participants because episodes involving fractures are considerably more costly than non-fracture episodes. While non-fracture episodes may cost $20-22,000, fracture episodes are typically 45-50% higher at $35-40,000.

Limitations on Usefulness of Recent CJR Data

HFMA recently published a short article about the data for the Comprehensive Care for Joint Replacement program that was released in August. However, we have some additional caveats that should be considered in using this data.

The Proposed Mandatory Medicare Bundled Payment Program - 15 Things to Know

Note: CMS has released the Final Rule for the CJR program. Updates descriptions of the program are at this and this link.

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